1. Field of the Invention
The present invention relates to a surgical apparatus for an endoscope and an exterior tube, and particularly, relates to a surgical apparatus for an endoscope provided with an exterior tube sheathed to an outer tube that guides an insertion part of a medical instrument into a body cavity, and an exterior tube.
2. Description of the Related Art
In recent years, since invasion to a patient is small compared to surgery in which a laparotomy, a thoracotomy, or the like, is performed, endoscopic surgery using endoscopes (hard endoscopes), such as a laparoscope, is widely performed. In the endoscopic surgery, a plurality of holes are made in a patient's body wall, an endoscope is inserted into a body cavity from one hole of them, and a treatment tool is inserted into the body cavity from another hole. Then, treatment of a living body tissue is performed with the treatment tool while observing the living body tissue within the body cavity with the endoscope.
Generally, in the endoscopic surgery, one or a plurality of treatment tools are used simultaneously with the endoscope. Therefore, since it is difficult for one operator to simultaneously operate the endoscope and the plurality of treatment tools, for example, a task where the operator operates treatment tools using both hands while making an assistant called an endoscopic technician operate the endoscope is normally performed.
In this way, in the endoscopic surgery, it is general that the operator's hands are bound by the operation of the treatment tool, and the operation of the endoscope is performed by the assistant. Therefore, in a case where the observation position of the endoscope is changed, the operator should serially give instructions to the assistant. Hence, the task of correctly directing the orientation of the endoscope to a direction desired by the operator is difficult, and stress is likely to be imposed on the operator. Additionally, since the assistant performs an operation after the operator issues an instruction, there is a tendency that surgery time is likely to be prolonged. Additionally, the assistant should operate the endoscope so as not to interfere with an operator's procedure, and the operation is likely to become complicated.
In contrast, the applicant of the present application suggests a technique in which an endoscope and a treatment tool are combined together by an outer tube, and if the treatment tool is moved forward and backward, the endoscope is also moved forward and backward in an interlocking manner with this movement of the treatment tool (refer to WO2013/176167A). Specifically, the outer tube that guides an insertion part of the endoscope and an insertion part of the treatment tool into a body cavity includes a tubular outer tube body that is inserted in a state where the insertion part of the endoscope and the insertion part of the treatment tool are made to be parallel to each other. An interlocking member that is movable forward and backward in an axial direction and has an endoscope-coupling part and a treatment tool-coupling part is provided inside the outer tube body. The insertion part of the endoscope and the insertion part of the treatment tool are held by the respective coupling parts of the interlocking member in a state where the insertion parts are made to be parallel to each other. If the insertion part of the treatment tool is moved in the axial direction, the insertion part of the endoscope also moves in the axial direction in an interlocking manner with this movement. Accordingly, the number of the holes made in the patient's body wall can be reduced, the invasion to the patient can be suppressed, and the visual field of the endoscope can be easily changed while an operator operates the treatment tool without asking for an assistant's help.
Additionally, an outer tube that enables a pneumoperitoneum gas to be supplied into a body cavity through an insertion passage through which an endoscope or a treatment tool are inserted is disclosed in JP1997-276287A (JP-H09-276287A).